week3 competencies only Flashcards
which cox is responsible for : bleeding tendencies and gastic muscoal damage?
cox-1
which OD of this analgesic is responsible for Compensated respiratory alkalosis then respiratory depression acidosis?
Aspirin
The OD A/E: Hepatic Necrosis, Hepatic Failure, coma, death… are common with this Rx
Acetaminophen (Tylenol)
which OD of this analgesic requires Tx such as : mechanical ventilation, external cooling, IV fluids, ACTIVATED Charcoal, bicarb, dyalisis
Aspirin
These OD side affects: N/V/D, sweating, diarrhea and abdominal discomfort, are common with this drug…
Acetaminophen (Tylenol)
which OD of this analgesic is responsible for a/e of stupor coma resp failure and even death
aspirin
which cox is responsible for : analgesia and anitinflammatory activity
cox-2
describe the main therapeutic uses of glucocorticoids for non-endocrine disorders
RA,Lupus, inflam bowel disease, inflam disorders, allergic reactions, sskin disorders, astham neoplasmas, supress organ rejection, prevent resp. distress syndrome in premature infants
Acetaminophen (Tylenol) s/e from OD are
N/V/D, sweating, and abdominal discomfort
which analgesic is responsible for these A/E’s after an OD : of hyperthermia, sweating, dehydration, electrolyte imbalance
aspirin
This is the Tx for Acetaminophen OD
ACETYLCUSTEINE (MUCUMYST) must give PO or IV within 8-10 after overdose
describe the appropriate discontinuation process of systemic glucocorticoids
slowly tapper off 7days
switch from multiple to singel dose
wean of drug-if abrupt stop-then CRISIS
withdrawl syndrome s/s: hypotension, myalgia ,arthralgia, fatigue
adverse effects of nsaids(aspirin, ibuprofen, celecoxib) are….
H/a,Drowziness, diziness,
Gi distress/bleeding,periph edema
Glucocorticoids-prednisone, predniSOLONE
S/E
euphoria,confusion, psychosis,H/A,insomnia,osteoperosis,
GI distress,gastric ulceration,
delayed wound healing, hyperglycemia
S/E of DMARDS-methotrexate(Rheumatrex), Sulfasalazine
H/A, infex, bone marrow supression,
hepatoxicity, pneumonitis, gi ulcer, glossitis, gingivitis, stomatitis, leukopenia, thrombocytopenia.increased deaths from CV disease, CA, fetal abnormalities and death.
S/E’s of DMARDS-Tumor necrosis factor (TNF) antagonists: etanercept(Enbrel).infliximab (remicade, adalimumab(Humira)
- serious Tb infex
- HF,MI,CA,Liver Dysfunx
- MS, panocytopenia
- H/a, Diziness, Rhinitis, cough,abd pain
- injecx site reacx, itching,
- erythema,swelling, pain
A/E’s of a DMARD-B Lymphocyte depleting agents: rituximab(Rituxan)
- Ftg/Fvr/ chills/ flushing
- N/V anorexia, abd pain
- Fatal infusion reacx:HypoTN,bronchospasm, angioedema, MI, cardiogenic shock.
- Dermatitis,Steven Johns Syndrome
- Hepatitis B reactivation
- Neutropenia, leukopenia, anemia, thrombocytopenia
A/E’s of DMARD-T-Cell activation inhibitors
Abatacept(Orencia)
- Headache, URI,nausea
- Increases risk of serious infection and cancer
A/E’s of JANUS KINASE (JAK) INHIBITORS
tofacitinib (Xeljanz)
- increased risk of serious infections tb, cancers, and lymphoma as well as high cholesterol, respiratory tract infections, H/A, Diarrhea
Describe action and A/E of
NSAIDS
indomethacin (Indocin), Naproxen(naprosyn), diclofenac (Voltaren)
- first DOC for acoute gouty arthritis
- better tolerated than colchecine, effects more predictable
- beneficial effects-supress inflamation
- relief w/in 24 hrs
Describe action and A/E of
HYPERURICEMICS-allopurinol (Zyloprim)
- DOC in ULT
- Action-inhibits uric acide formation and prevents tophus formation, causes tophi resression
- A/Es are fatal hypersensitivity syndrome
- Gi distress
- neruologic effects
- may cause cataracts
Action and A/E’s
probenecid (generic only)
action: inhibits reabsorption or uric acid in renal tubules
A/E: Gi effects, hypersensitivity reacx, renal injury
what are Colchicine’s action and A/E’s?
Action: anti inflammatory specific to gout
A/E: N/V/D/abdPain
- D/C drug when Gi symptoms develop
- bone marrow supression
- rhabdomyolosis
Describe drug therapy for osteoperosis using
calcitonin-Salmon(miacalcin, fortical)
Action and A/E:
- inhibits osteoclastic activity by decreasing bone resorption and increases calcium excretion
- A/E: nasal druness and irritation
- nausea, flushing oif face and hands
- inflammatory injection site reacx
describe drug therapy for osteoperosis using such drugs as: Biophosphonates-alendronate(Fosamax), ibanddronate (Boniva)-PO
ACTION and A/E:
- muscular skeletal pain
- occular inflamax, esophatitis
- osteonecrosis of jaw, femur fractures
- Hyperparathyroidism, A-Fib
describe drug therapy for osteoperosis using such drugs as: Selective Estrogen receptor modulators(SERM’s)-raloxifine (EVISTA)-PO
ACTION and A/E:
- Action: bond to estrogen receptors selectivly
- Mimics estrogen effects on bone, lipid metabolism, blood clotting, blocks estrogen effects in breast and endometrium
- A/E: venous thromboembolism, hot flashes, fetal harm
describe drug therapy for osteoperosis using such drugs as:Teriparatide (Forteo)-given daily subq
ACTION and A/E:
- ACTION: only approved drug to increase bone formation in osteoperosis
- A/E: N/HA, back pain, leg cramps, orthostatic hypotension, dizziness, bone cancer
- elevated levels of Calcium, mg, uric acid
describe drug therapy for osteoperosis using such drugs as: Monoclonal decreases osteoclast formation and funcx (Rankl inhibitor)
ACTION and A/E:
- A/E: pain in back and extremeties
- hypercholesterolemia
- urinary bladder infecx
- hypercalcemia, serious infex
- Rashes, osteonecrosis of jaw
